PROLONGED PH MONITORING IS OF LIMITED USEFULNESS FOR GASTROESOPHAGEALREFLUX

Objective.-To assess the diagnostic value of pH monitoring. Design.-A prospective study. Setting.-Pediatric university hospital serving as a secondary and tertiary referral center. Participants.-Thirty-eight in fants, aged 1 to 12 months, and 26 children, aged 13 months to 18 year s, admitted during a 2-year period because of clinically significant g astroesophageal reflux (GER). Interventions.-Prolonged (20-hour) pH mo nitoring as well as endoscopy and biopsy of the esophagus were carried out in all patients who, on the basis of clinical data, were classifi ed as having mild, moderate, or severe GER disease. Results.-In the in fant group, results of prolonged pH monitoring were abnormal in 34 (89 .5%). In the older group, results were abnormal in less than half (11 [42.3%]) of the cases. In both groups, pH monitoring data did not corr elate with the severity of GER disease or of esophagitis. Severity of GER disease was not predictive of esophagitis. Conclusions.-(1) Endosc opy and biopsy of the esophagus should be the first procedures wheneve r there are clinical findings of moderate to severe GER disease. (2) M onitoring of pH should be restricted to those patients without a clear -cut histor of GER disease.